Tobacco use remains a leading and persistent global public health crisis, contributing to premature death and significant morbidity, various cancers, cardiovascular diseases, adverse perinatal outcomes, and cognitive decline in later life.
Trinity College Dublin (TCD) plays a vital role in this effort, conducting diverse research aimed at understanding the burden of tobacco use, evaluating interventions, and generating evidence to support effective health policies.
Key Areas of Research at TCD & Impact on Health Policy & Public Practice
- Smoking Cessation Interventions and Policy Implementation:
◦ We Can Quit2 (WCQ2): TCD researchers have applied a novel evaluation tool (i.e., PECIS-2) using a pilot cluster randomised controlled trial of a community-based smoking cessation intervention for women in disadvantaged areas. This approach facilitated discussions on engagement barriers and led to the co-creation of recommendations and policy priorities, aligning with the national Healthy Ireland Strategic Action Plan.
◦ Financial Incentives Realist Review: The Centre for Health Policy and Management at TCD conducted a realist review to help the HSE and the Tobacco Free Ireland programme understand how financial incentives work to help people stop smoking, for whom, in what circumstances, and why.
◦ Smoke-Free Campus Living Lab: TCD implemented and evaluated a smoke-free campus policy using a Living Lab methodology to assess policy adherence. The Living Lab approach proved valuable for policy implementation, identifying areas like "social smoking" patterns and contributing to a broader health promotion strategy.
- Understanding Health Harms Linked to Tobacco Use:
◦ Research highlights tobacco as a major modifiable risk factor for various cancers. Studies involving TCD researchers examine the burden of such risk factors among people with Lynch Syndrome, benchmarking against international guidelines for cancer prevention.
◦ The effects of different smoking patterns during pregnancy on perinatal outcomes have been studied, demonstrating that reducing smoking can mitigate some harmful effects.
◦ Utilising data from large national studies like Growing Up in Ireland (GUI), researchers investigate the patterns of smoking and e-cigarette use in young adults with disabilities. GUI data also includes early life exposures, such as "smoke in house in pregnancy," which TCD researchers use to explore potential links to childhood mental health outcomes.
By quantifying tobacco's role as a modifiable risk factor across multiple health outcomes. TCD research provides robust evidence that consistently underscores the public health message that "tobacco is bad for you".
- Tobacco and Aging/Cognitive Health:
◦ TCD's Irish Longitudinal Study on Ageing (TILDA) research revealed that lowering smoking rates can have positive impacts on cognitive health in later life.
◦ Broader research using meta-analytical and systematic review approaches also includes smoking as a lifestyle factor considered in relation to healthy aging, including cognition and functional ability. Studies employing methods like sparse canonical correlation analysis (sCCA) on data like the IMAGEN study have identified parental smoking as an environmental source influencing adolescent brain structure alongside factors like age, sex, and lifestyle choices.
Research findings, particularly from studies like WCQ2 and TILDA, contribute to the evidence base used by bodies like the HSE and align with national priorities such as the Tobacco Free Ireland strategy and the Healthy Ireland plan.
TCD's involvement in international collaborations and guidelines (e.g., on lung cancer screening, cardiovascular prevention) further extends the reach and impact of its research.